Banks W A, Cooper J A
Veterans Administration Medical Center, Orleans, LA 70146.
South Med J. 1990 Mar;83(3):290-3. doi: 10.1097/00007611-199003000-00009.
Previous studies have suggested that the hypoxia and/or hypercapnia associated with chronic lung diseases may lead to pituitary and gonadal dysfunction, with destruction of the sella turcica. It is unclear, however, whether these abnormalities were due to lung disease or to confounding factors. We studied the relationships between hormonal levels (triiodothyronine, thyroxine, T3 resin uptake, thyrotropin, prolactin, cortisol, and testosterone) and PaO2, PaCO2, pH, and alveolar-arterial gradient in 25 patients with chronic lung disease. These patients were highly homogeneous for diagnosis, age, sex, ambulatory status, lack of other illnesses, and minimal use of medications unrelated to lung disease, but did have various degrees of hypoxia and hypercarbia at the time of study. We found no relationship between hormonal levels and lung function, or evidence of major pituitary involvement on lateral roentgenograms of the skull, CT of the sella turcica, or stimulation of the pituitary. An inverse correlation did occur between serum levels of thyroxine and the daily dose of oral prednisone. We conclude that most of the endocrine dysfunction ascribed to chronic lung diseases is probably due to factors other than hypoxia or hypercarbia.
先前的研究表明，与慢性肺部疾病相关的低氧血症和/或高碳酸血症可能导致垂体和性腺功能障碍，并伴有蝶鞍破坏。然而，尚不清楚这些异常是由于肺部疾病还是混杂因素所致。我们研究了25例慢性肺部疾病患者的激素水平（三碘甲状腺原氨酸、甲状腺素、T3树脂摄取、促甲状腺激素、催乳素、皮质醇和睾酮）与动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）、pH值及肺泡-动脉血氧分压差之间的关系。这些患者在诊断、年龄、性别、活动状态、无其他疾病以及极少使用与肺部疾病无关的药物方面具有高度同质性，但在研究时确实存在不同程度的低氧血症和高碳酸血症。我们发现激素水平与肺功能之间无关联，在头颅侧位X线片、蝶鞍CT或垂体刺激检查中也未发现垂体受累的主要证据。血清甲状腺素水平与口服泼尼松的每日剂量之间存在负相关。我们得出结论，归因于慢性肺部疾病的大多数内分泌功能障碍可能是由低氧血症或高碳酸血症以外的因素引起的。
